For many in my fearful, frustrated generation, “having it all” means opting out of monogamy

Polyamory, if you believe the news­papers, is the hot new lifestyle option for affectless hipsters with alarming haircuts, or a sex cult, or both. A wave of trend articles and documentaries has thrown new light on the practice, also known as “ethical non-monogamy” – a technical term for any arrangement in which you are allowed to date and snuggle and sleep with whomever you want, as long as everyone involved is happy. Responses to this idea range from parental concern to outright panic.

Having been polyamorous for almost a decade, I spend a good deal of time explaining what it all means. When I told my editor that I wanted to write about polyamory, she adjusted her monocle, puffed on her pipe and said, “In my day, young lady, we just called it shagging around.” So I consider it my duty to her and the rest of the unenlightened to explain what’s different about how the kids are doing it these days.

The short answer is: it’s not the shagging around that’s new. There is nothing new about shagging around. I hear that it has been popular since at least 1963. What’s new is talking about it like grown-ups. It’s the conversations. It’s the texts with your girlfriend’s boyfriend about what to get her for her birthday. It’s sharing your Google Calendars to make sure nobody feels neglected.

The Daily Mail would have you believe that polyamory is all wild orgies full of rainbow-haired hedonists rhythmically thrusting aside common decency and battering sexual continence into submission with suspicious bits of rubber. And there is some truth to that. But far more of my polyamorous life involves making tea and talking sensibly about boundaries, safe sex and whose turn it is to do the washing-up.

Over the past ten years, I have been a “single poly” with no main partner; I have been in three-person relationships; I have had open relationships and have dated people in open marriages. The best parts of those experiences have overwhelmingly been clothed ones.

There’s something profoundly millennial about polyamory, something quintessentially bound up with my fearful, frustrated, overexamined generation, with our swollen sense of consequence, our need to balance instant gratification with the impulse to do good in a world gone mad. We want the sexual adventure and the free love that our parents, at least in theory, got to enjoy, but we also have a greater understanding of what could go wrong. We want fun and freedom, but we also want a good mark in the test. We want to do the right thing.

All of this makes polyamory sound a bit nerdy, a bit swotty – and it is. I find myself bewildered when online trend pieces aiming for titillation clicks present polyamory as gruesomely hip or freakishly fashionable. Polyamory is a great many things, but it is not cool. Talking honestly about feelings will never be cool. Spending time discussing interpersonal boundaries and setting realistic expectations wasn’t cool in the 1970s, and it isn’t cool now. It is, however, necessary.

There is so little that makes ethical sense in the lives of young and youngish people today. If there is an economic type that is over-represented among the poly people I have encountered, it is members of the precariat: what Paul Mason memorably called the middle-class “graduate with no future”.

Even the limited social and economic ­certainties that our parents grew up with are unavailable to us. We are told, especially if we are women, that the answer to loneliness and frustration is to find that one ideal partner who will fulfil all our emotional, financial, domestic and sexual needs. We are told this even though we know full well that it doesn’t work out for a lot of people. Almost half of all marriages end in divorce.

Paradoxically, as religious patriarchy has loosened its moral grip on the West, the doctrine of monogamous romance has become ever more entrenched. Marriage was once understood as a practical, domestic arrangement that involved a certain degree of self-denial. Now your life partner is also supposed to answer your every intimate and practical need.

Polyamory is a response to the understanding that, for many of us, this ideal is impractical, if not an active cause of unhappiness. People have all sorts of needs through their lives – love, companionship, care and intimacy, sexual adventure and self-expression – and expecting one person to be able to meet all of them is not only unrealistic, it’s unreasonable. Women in particular, who often end up doing most of the emotional labour in conventional, monogamous, heterosexual relationships, don’t have the energy to be anyone’s everything.

I don’t expect anyone to be everything to me. I want freedom, and I want to be ethical, and I also want affection and pleasure. I guess I’m greedy. I guess I’m a woman who wants to have it all. It’s just that my version of “having it all” is different from the picture of marriage, mortgage and monogamy to which I was raised to aspire.

Not all polyamorous relationships work out – and nor do all conventional relationships. We’re making it up as we go along. It would be helpful to be able to do that without also having to deal with prejudice and suspicion. Still, it’s easy to see where the suspicion comes from. The idea of desire without bounds or limits is threatening. It is a threat to a social order that exerts control by putting fences around our fantasies. It is a threat to a society that has developed around the idea of mandatory heterosexual partnership as a way to organise households. It is threatening because it is utopian in a culture whose imagination is dystopian. Freedom is often frightening, and ­polyamory is about balancing individual freedom with mutual care. In this atomised culture, that’s a revolutionary idea.

David had taken the same tablets for years. Why the sudden side effects?

David had been getting bouts of faintness and dizziness for the past week. He said it was exactly like the turns he used to get before he’d had his pacemaker inserted. A malfunctioning pacemaker didn’t sound too good, so I told him I’d pop in at lunchtime.

Everything was in good order. He was recovering from a nasty cough, though, so I wondered aloud if, at the age of 82, he might just be feeling weak from having fought that off. I suggested he let me know if things didn’t settle.

I imagined he would give it a week or two, but the following day there was another visit request. Apparently he’d had a further turn that morning. The carer hadn’t liked the look of him so she’d rung the surgery.

Once again, he was back to normal by the time I got there. I quizzed him further. The symptoms came on when he got up from the sofa, or if bending down for something, suggesting his blood pressure might be falling with the change in posture. I checked the medication listed in his notes: eight different drugs, at least two of which could cause that problem. But David had been taking the same tablets for years; why would he suddenly develop side effects now?

I thought I’d better establish if his blood pressure was dropping. I got him to stand, and measured it repeatedly over a period of several minutes. Not a hint of a fall. And nor did he now feel in the slightest bit unwell. I was stumped. David’s wife had been watching proceedings from her armchair. “Mind you,” she said, “it only happens mid-morning.”

The specific timing made me pause. I asked to see his tablets. David passed me a carrier bag of boxes. I went through them methodically, cross-referencing each one to his notes.

“Well, there’s your trouble,” I said, holding out a couple of the packets. One was emblazoned with the name “Diffundox”, the other “Prosurin”. “They’re actually the same thing.”

Every medication has two names, a brand name and a generic one – both Diffundox and Prosurin are brand names of a medication known generically as tamsulosin, which improves weak urinary flow in men with enlarged prostates. Doctors are encouraged to prescribe generically in almost all circumstances – if I put “tamsulosin” on a prescription, the pharmacist can supply the best value generic available at that time, but if I specify a brand name they’re obliged to dispense that particular one irrespective of cost.

Generic prescribing is good for the NHS drug budget, but it can be horribly confusing for patients. Long-term medication keeps changing its appearance – round white tablets one month, red ovals the next, with different packaging to boot. And while the box always has the generic name on it somewhere, it’s much less prominent than the brand name. With so many patients on multiple medications, all of which are subject to chopping and changing between generics, it’s no wonder mix-ups occur. Couple that with doctors forever stopping and starting drugs and adjusting doses, and you start to get some inkling of quite how much potential there is for error.

I said to David that, at some point the previous week, two different brands of tamsulosin must have found their way into his bag. They looked for all the world like different medications to him, with the result that he was inadvertently taking a double dose every morning. The postural drops in his blood pressure were making him distinctly unwell, but were wearing off after a few hours.

Even though I tried to explain things clearly, David looked baffled that I, an apparently sane and rational being, seemed to be suggesting that two self-evidently different tablets were somehow the same. The arcane world of drug pricing and generic substitution was clearly not something he had much interest in exploring. So, I pocketed one of the aberrant packets of pills, returned the rest, and told him he would feel much better the next day. I’m glad to say he did.